Unusual manifestations of abdominal aortic aneurysms

Repair of an asymptomatic infrarenal abdominal aortic aneurysm is straightforward and can be accomplished with low morbidity and mortality rates. However, certain complications of abdominal aortic aneurysm, such as contained rupture, inflammatory aneurysm, aortovenous fistula, infected aneurysm, primary aortoenteric fistula, and lower-extremity atheroembolism can be both limb- and life-threatening. Unusual signs and symptoms in a patient with an abdominal aortic aneurysm should alert the physician to the possibility of one of these complications. Careful history-taking and physical examination and appropriate diagnostic imaging, combined with a well-planned operation, will minimize the morbidity and mortality rates otherwise associated with these complications.